Website HEALTHINDIA INSURANCE TPA SERVICES PRIVATE LIMITED
| Position Title: |
Medical Officer
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| Position Type: |
Regular
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Reason For Vacancy: |
New Position
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| Location: |
Mumbai
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Working Hours: |
Full Time
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| Reports to: |
Department Head
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Department: |
Claims Department
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| Main responsibilities and Opportunities: |
• Medical Scrutiny
• Provide Medical opinion for Health Insurance Claims • Processing of Cashless Requests & Health Insurance Claim Documents • Proficient with medical terms & system. • Understanding of Policy terms & conditions & Various Protocols / Guidelines • Understanding of Claims adjudication / Claims Processing • Maintaining & Ensuring Standard Operating Procedures & Protocols • Ailment Wise ICD & Procedure Coding • Manage volumes effectively & efficiently to maintain Turnaround time of processing cases • VIP Claims Processing and TAT Maintenance • Processing Error to be maintained < 0.25% • Claim Case Management / Cost Management |
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| Qualifications, Work Experience: |
Essential:• At least 1 yrs experience in Medical Officer Claims Processing Cashless. Desirable:BAMS / BHMS /MBBS etc (BDS to be avoided) Work Experience:Min experience 6 months to 1 year in a TPA |
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| Knowledge (Language, IT skills etc): |
Essential:• Understand enterprise architecture in health care and public health organizations
• Knowledge of health insurance • Well versed with medical terminologies. • Computer knowledge |
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| Personal Skills: |
Communication Skill, Interpersonal Skill
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